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When Eating Disorders Develop at a Young Age

For the longest time, Amy’s mother didn’t think there was anything wrong with her daughter needing to go to the bathroom every time right after meals. Her youngest had trouble with a “nervous stomach,” as she called it, for as long as she could remember. Eventually, though, she became concerned with her child’s weight. At the age of 11, Amy was five feet tall but weighed less than 60 pounds.

“All the popular kids in her class are super thin,” she told me when we first met for a consultation at my practice. “It’s the look they see and adore on TV and the Internet.”

Dieting for looks is not unusual among young girls. The message that “you can’t be too thin” is conveyed to all of us by the media. But because children are far more impressionable than adults, they tend to take these beliefs much more to heart and act accordingly. Peer pressure, the desire to live up to certain fashion standards as well as body changes during the early stages of puberty are all well-known factors that can contribute to the development of eating disorders at a young age.

Of course, weight-consciousness does not automatically result in eating disorders. The issue of dieting during childhood has only come to the forefront with the ever-growing childhood obesity epidemic. Still, clinical studies have found that children who diet for weight loss are much more likely to develop dysfunctional eating habits later in life.

What are eating disorders?
Eating disorders are foremost psychological disturbances. People who suffer from eating disorders have a dysfunctional relationship to food. Fear of becoming overweight – and therefore unattractive – is only one of many possible causes, although a common one. This state of mind is clinically called “anorexia nervosa” (AN), which is derived from the Greek words an, meaning “without,” and orexis, meaning appetite. Taken literally, however, the term is somewhat misleading. Anorexics don’t starve themselves because of lack of appetite. Rather, they are afraid of what eating even small amounts of food can do to their body image. Especially girls and young women who work (or aspire to work) as photo models in the fashion industry or have athletic ambitions are at risk of developing anorexia.

Another frequently occurring form of eating disorder is called “bulimia nervosa” (BN), which can include regular bouts of overeating or binge eating followed by self-induced vomiting or use of laxative to prevent weight gain. Like anorexics, bulimics are deeply concerned about their body image, but because their eating patterns are inconsistent, they resort to extreme measures to undo the perceived damage.

On the other end of the spectrum, there is a behavior called “binge eating disorder” (BED), which results in compulsive overeating without subsequent countermeasures to avoid weight gain. Those suffering from BED are likely to face weight problems eventually.

All eating disorders carry great health risks, especially when they start early in life. Potentially serious harm is not only caused to the physical- but also the mental health and well-being of those who engage in this kind of dysfunctional behavior.

How does one recognize and treat eating disorders?
Regrettably, eating disorders among children are not yet sufficiently understood both by science and the public. Parents are often not equipped to deal appropriately with the phenomenon. Sometimes, it can be hard to even recognize the symptoms of unhealthy behavior when kids go through different phases of growing up.

But if there are any indications that something is amiss, parents should look for a number of potential warning signs, such as rapid changes in eating patterns, self-imposed dieting, skipping meals or refusing to eat in the presence of other family members. Parents who find their kids taking diet pills or laxatives on their own and without supervision should definitely be alarmed. Other possible indicators are changes in physical appearance, like swelling of the cheeks or jaw or stained teeth and bad breath from self-induced vomiting.

When parents become aware of this kind of behavior, they must take action at once and get professional help for their kids if necessary. Effective treatment of eating disorders may require consultations with several health care specialists besides your family doctor, possibly a pediatrician, psychiatrist and nutrition therapist.

Parents may have to participate in the therapeutic process as well. Eating disorders do normally not develop in a vacuum. Older siblings, friends, classmates, even the parents themselves can contribute to a child’s disturbed relationship to food.

There are a number of proactive measures concerned parents can take. For starters, it is important to maintain a healthy “food culture” at home. Children should learn from early on to appreciate the value of good nutrition. Food-oriented family activities, like grocery shopping and farmers market visits, growing a vegetable garden or preparing meals together can help promote healthy eating habits. Food should never be used as means of reward or punishment.

It is up to the adults to be good role models. That includes open discussions about issues of physical beauty and self-esteem. If parents deal with negative body images themselves and convey these by, let’s say, obsessive dieting or fitness training, they are likely to pass their sentiments on to their kids as well. As it is often the case, leading by good example may be the best approach to get everybody back on track.

Timi Gustafson R.D. is a clinical dietitian and author of “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

Note: This is a seattlepi.com reader blog. It is not written or edited by the P-I. The authors are solely responsible for content. E-mail us at newmedia@seattlepi.com if you consider a post inappropriate..